If you're seeing this message, it means we're having trouble loading external resources on our website.

If you're behind a web filter, please make sure that the domains *.kastatic.org and *.kasandbox.org are unblocked.

# Challenging beliefs to prevent eating disorders

## Problem

Current literature suggests that only 30, percent of individuals diagnosed with eating disorders are able to fully recover. Because treatment outcomes are poor, more psychologists are focusing their efforts on prevention. A clinical psychologist develops a program for women with body image concerns. The program specifically targets thin ideal internalization, or the extent to which a woman believes that the ultra-thin, feminine ideal of beauty is related to happiness, success, and self-worth. Greater thin-ideal internalization is associated with development of eating disorder symptoms. To decrease thin-ideal internalization, the program requires participants to actively critique the thin ideal in a series of activities and exercises (like role-play games that challenge the importance of shape and weight and a writing assignment that discusses the dangers of dieting and unhealthy behaviors). Because participants will actively critique their long-held beliefs, the psychologists hypothesize that the activities in the program will produce cognitive dissonance, and the discomfort the participants feel will motivate them to change their attitudes and beliefs regarding the thin-ideal and body image.
A group of 400 women between the ages of 18 and 35 are recruited to participate in a study to evaluate the program’s effectiveness. 200 women are assigned to the dissonance program and 200 are assigned to a wait-list control group to receive the program at a later date. All participants complete questionnaires about eating disorder symptoms, body dissatisfaction, and thin ideal internalization pre and post-intervention. The present analysis examines data from the the first 200 women assigned to the dissonance program, with those participants divided into three cohorts based upon age. Cohort A (n = 78) includes participants between the ages of 18 and 23, Cohort B (n = 62) includes participants between the ages of 24-29, and Cohort C (n = 60) includes participants between the ages of 30-35. Table 1 presents pre- and post-test means for each cohort in the intervention group. The means are generated from likert-style ratings of symptoms and feelings, with higher numbers indicating higher levels of pathological ideals and symptoms, and lower numbers indicating lower levels of pathological ideals and symptoms. Means of thin-ideal internalization and body dissatisfaction have a potential range of 1-4; means of eating symptoms have a potential range of 5-30.
Table 1Cohort ACohort BCohort C
Thin-ideal Pre3, point, 603, point, 633, point, 60
Post2, point, 90*3, point, 0*3, point, 58
Body dissatisfaction Pre3, point, 613, point, 513, point, 51
Post2, point, 92*2, point, 86*3, point, 50
Eating symptomsPre25, point, 5017, point, 2513, point, 58
Post10, point, 02*6, point, 27*13, point, 42
*Statistically significant differences in scores from pre to post at p<0, point, 5.
One participant from Cohort A reports high levels of eating disorder symptoms and thin-ideal internalization. This would indicate that being thin is incredibly important to her and that she feels that her shape and weight define her worth as a person. Which of the following actions could make her most uncomfortable and cause her to feel dissonance during the program?